Individual
DAVID M LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
940 STANTON L YOUNG BLVD, STE. 451, OKLAHOMA CITY, OK 73104-5020
(405) 271-2422
Mailing address
1122 NE 13TH ST, ORI236, OKLAHOMA CITY, OK 73117-1039
(405) 271-1515
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
5508
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800522089
GROUP MEDICARE
OK
Enumeration date
03/16/2006
Last updated
05/28/2008
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